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Research

Accident and emergency department attendance rates of people experiencing homelessness by GP registration: a retrospective analysis

Johanna Reilly, Khalil Hassanally, John Budd and Stewart Mercer
BJGP Open 2020; 4 (5): bjgpopen20X101089. DOI: https://doi.org/10.3399/bjgpopen20X101089
Johanna Reilly
1Academic Clinical Fellow, Usher Institute, University of Edinburgh, Edinburgh, UK
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  • For correspondence: johanna.reilly@ed.ac.uk
Khalil Hassanally
1Academic Clinical Fellow, Usher Institute, University of Edinburgh, Edinburgh, UK
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John Budd
2GP, Edinburgh Access Practice, NHS Lothian, Edinburgh, UK
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Stewart Mercer
3Professor of Primary Care, Usher Institute, University of Edinburgh, Edinburgh, UK
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Article Figures & Data

Tables

    • View popup
    Table 1. Demographics and reasons for attendance
    SexaSHHP, n =670, n (%)Other, n =454, n (%)Significance
      Male524 (78.2)275 (60.6)P = 0.001
      Female146 (21.8)178 (39.2) 
    Age range, yearsaSHHP, n =670Other, n =454P = 0.001
      18–2458 (8.7)93 (20.5) 
      25–2997 (14.5)76 (16.7) 
      30–34142 (21.2)79 (17.4) 
      35–39110 (16.4)81 (17.8) 
      40–44103 (15.4)47 (10.4) 
      45–4944 (6.6)17 (3.7) 
      50–5430 (4.5)16 (3.5) 
      55–5915 (2.2)8 (1.8) 
      60–646 (0.9)3 (0.7) 
      65–696 (0.9)3 (0.7) 
      ≥703 (0.4)5 (1.1) 
    Rough sleepingaSHHP, n =670Other, n =454P = 0.839
      Yes112 (16.7)78 (17.2) 
      No558 (83.3)376 (82.8) 
    ReasonsSHHP, n =2545Other, n =1554P = 0.026
      Medical540 (21.2)353 (22.6) 
      Surgical150 (5.9)134 (8.6) 
      Trauma376 (14.8)272 (17.4) 
      Alcohol385 (15.1)182 (11.7) 
      Drugs579 (22.8)197 (12.6) 
      Mental health164 (6.4)189 (12.1) 
      Unknown or did not wait229 (9.0)113 (7.2) 
      Social or other122 (4.8)119 (7.6) 
    TriageSHHP, n =2545Other, n =1554P = 0.08
      Immediate resus165 (6.5)75 (4.8) 
      Very urgent329 (12.9)204 (13.1) 
      Urgent1285 (50.5)804 (51.6) 
      Standard605 (23.8)318 (20.4) 
      See and treat89 (3.5)110 (7.1) 
      Redirect or medical expected18 (0.7)13 (0.8) 
    ReferredSHHP, n =2545Other, n =1554P = 0.1
      No1729 (67.9)1111 (71.3) 
      Yes816 (32.1)448 (28.7) 
    • aN = 1124 patients; n = 101 excluded because of registration with a non-local GP or with no GP. SHHP = specialist homeless health provider.

    • View popup
    Table 2. Frequency of attendance, N = 1124
    Frequency of attendance during study periodSHHP count (% of SHHP patients),
    n = 670
    Other count (% of other patients),
    n = 454
    Significance
    1276 (41.2)214 (47.1)P = 0.24
    2137 (20.4)85 (18.7) 
    369 (10.3)53 (11.7) 
    449 (7.3)27 (5.9) 
    ≥5139 (20.7)75 (16.6) 
    • SHHP = specialist homeless health provider.

    • View popup
    Table 3. Mean attendances
    Mean attendances over 2.5yearsn Standard deviation
      SHHP3.86.0P = 0.08
      Other3.67.6 
    Mean repeat attendances (excluding one-time attenders) 
      SHHP5.87.2P = 0.251
      Other5.99.5 
    • SHHP = specialist homeless health provider.

    • View popup
    Table 4. Attendance by sex
    Attendances during study perioda1234≥5
    Male, n (%)335 (41.9)164 (20.45)90 (11.3)53 (6.6)158 (19.8)
    Female, n (%)155 (47.8)58 (17.9)32 (9.9)23 (7.1)56 (17.3)
    Significance, Mann-Whitney U testP = 0.108
    • aPercentages calculated from relevant sex N-value; male n = 800; female n = 324.

    • View popup
    Table 5. Attendance by age range (years)
    Attendances over study period, n (%)a1234≥5
    18–2465 (43.0)32 (21.2)21 (13.9)5 (3.3)28 (18.5)
    25–2966 (38.2)32 (18.5)23 (13.3)17 (9.8)35 (20.2)
    30–3493 (42.1)35 (15.8)28 (12.7)17 (7.7)48 (21.7)
    35–3989 (46.6)44 (23.0)14 (7.3)14 (7.3)30 (15.7)
    40–4461 (40.7)35 (23.3)16 (10.7)11 (7.3)27 (18.0)
    45–4946 (50.5)20 (22.0)5 (5.5)3 (3.3)17 (18.7)
    50–5427 (44.3)14 (23.0)6 (9.8)4 (6.6)10 (16.4)
    55–5923 (50.0)5 (10.9)7 (15.2)2 (4.3)9 (19.6)
    60–6412 (52.2)1 (4.3)0 (0.0)2 (8.7)8 (34.8)
    65–693 (33.0)3 (33.0)1 (11.0)0 (0.0)2 (22.2)
    ≥705 (62.0)1 (12.5)1 (12.5)1 (12.5)0 (0.0)
    Significance, Kruskal-WallisP = 0.5
    • aPercentages calculated from relevant age group N-value.

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Accident and emergency department attendance rates of people experiencing homelessness by GP registration: a retrospective analysis
Johanna Reilly, Khalil Hassanally, John Budd, Stewart Mercer
BJGP Open 2020; 4 (5): bjgpopen20X101089. DOI: 10.3399/bjgpopen20X101089

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Accident and emergency department attendance rates of people experiencing homelessness by GP registration: a retrospective analysis
Johanna Reilly, Khalil Hassanally, John Budd, Stewart Mercer
BJGP Open 2020; 4 (5): bjgpopen20X101089. DOI: 10.3399/bjgpopen20X101089
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Keywords

  • inequalities
  • community care
  • socioeconomic factors
  • emergency service, hospital
  • harm reduction
  • people experiencing homelessness

More in this TOC Section

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  • Primary care physicians’ perceptions of social determinants of health recommendations: a qualitative study
  • Variation in laboratory testing for patients with long-term conditions: a longitudinal cohort study in UK primary care
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